Детерминанты инсулинорезистентности у взрослых индонезийцев, не страдающих диабетом: многомерный анализ факторов метаболизма, питания и образа жизни

Введение. Инсулинорезистентность (ИР), основной предшественник диабета второго типа, встречающаяся у 44,2 % индонезийцев, оценивалась с помощью индекса триглицеридов-глюкозы (TyG) как более практичного и экономичного показателя. В Индонезии комплексные исследования зависимости между факторами метаболизма, питания и образа жизни и ИР по-прежнему проводятся редко.

Цель: оценить факторы метаболизма, питания и образа жизни, связанные с инсулинорезистентностью, у взрослых жителей Индонезии, не страдающих диабетом.

Материалы и методы. В нашем поперечном исследовании использовались первичные данные когортного исследования факторов риска неинфекционных заболеваний, проведенного в Богоре, Индонезия. Из 5329 респондентов 251 участник с уровнем глюкозы натощак ≥ 126 мг/дл и 463 человека с неполными данными были исключены, вследствие чего итоговая выборка составила 4615 респондентов. Инсулинорезистентность определялась по индексу TyG ≥ 8,5. Переменные с p < 0,25 в критериях хи-квадрат были включены в многофакторную логистическую регрессию для выявления независимых предикторов. Были получены отношения шансов (ОШ) и 95 % доверительные интервалы (ДИ).

Результаты. Многофакторный анализ выявил несколько сильных предикторов индекса TyG среди взрослых без диабета. Наибольшая корреляция с индексом триглицеридов-глюкозы была установлена для принадлежности к мужскому полу (ОШ = 3,90, 95 % ДИ: 3,15–4,82), высокого уровня общего холестерина (ОШ = 4,36, 95 % ДИ: 3,72–5,11) и низкого уровня холестерина ЛПВП (ОШ = 4,24, 95 % ДИ: 3,62–4,97). Наиболее выраженный эффект, связанный с питанием, наблюдался при частом употреблении пакетированных напитков (>3 упаковок в день) (ОШ = 5,10, 95 % ДИ: 1,38–18,82). Также значимыми предикторами оказались центральное (абдоминальное) ожирение (ОШ = 2,39, 95 % ДИ: 2,01–2,84) и возраст от 40 лет (ОШ = 1,67, 95 % ДИ: 1,41–1,98).

Заключение: инсулинорезистентность (индекс TyG ≥ 8,5) значимо связана с метаболизмом, питанием и модифицируемыми факторами образа жизни и может служить практическим инструментом скрининга городского населения.

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